Individual
BETHANY ANNE BLONIGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1500 NORTHWAY DR, SAINT CLOUD, MN 56303-1219
(320) 253-7700
Mailing address
2205 26TH ST S, SAINT CLOUD, MN 56301-9116
(320) 249-0755
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14592
MN
Other
Enumeration date
04/05/2021
Last updated
04/10/2025
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